Curing a chronic illness

Things started changing for the good after the Lok Adalat cracked the whip on hospitals defaulting on waste disposal

BIOMEDICAL waste or BMW, that hazardous hospital discharge has risen by a substantial 25 per cent over the last five years, forcing the Lok Adalat to crack the whip on hospitals, both government and private.

While most big government hospitals and a few corporate health facilities in the City have set up effluent treatment plants (ETPs) and upgraded their existing sewage treatment plants, there are many smaller hospitals, nursing homes and clinics yet to fall in line.

Much has changed since the Lok Adalat’s diktat that hospitals which don’t comply would be closed down. The City cannot afford any laxity in this regard, since Bangalore has emerged as an international medical tourism hub. Besides, biomedical waste always runs the risk of triggering the spread of deadly diseases in the community.

The hospitals had to finally abandon the old practice of dumping their waste either along with other common garbage, or resorting to deep burial. The rather dangerous practice of letting out the liquid waste generated from laboratories and operation theatres into the BWSSB sewage pipelines without disinfecting had to be stopped too.

Slow progress

The progress of implementing a safer, more scientific process has been slow. The State government had specified the rules way back in 2000. But it took the Lok Adalat’s landmark order in 2009 to change things drastically for the better.

The order came down heavily on 14 hospitals, government and private, directing them to set up facilities for disposal of BMW in compliance with the rules. With the Karnataka State Pollution Control Board (KSPCB) issuing closure notices to some major government hospitals in the City, the urgency of setting up BMW facilities gathered momentum.

It had the desired result. Most major and medium hospitals and health care units in the city either set up ETPs to disinfect the liquid waste, or tied up with Common Biomedical Waste Treatment Facilities (CBMWTF) for disposing of solid waste.

As water consumption in government hospitals was quite high, the Lok Adalat asked them to set up ETPs, since the treated water could be reused, thereby bringing down the water bill.

Today, government hospitals, including the Sri Jayadeva Institute of Cardiology, Jayanagar General Hospital, K C General Hospital, Kidwai Memorial Institute on Oncology, Victoria Campus (which includes Victoria Hospital, Vani Vilas Hospital, Minto Eye Hospital, Institute of Nephro Urology Unit, Government Dental College) and the Bowring and Lady Curzon hospital have all set up ETPs.

City hospitals had their own incinerators till the Biomedical Waste Rules came into existence in 1998.

Today, many of those who don’t have their own ETPs have tied up with either of the two CBMWTFs run by the private companies Maridi Eco Industries Pvt Ltd, and Ramky Enviro Engineers Ltd. While Maridi’s facility is located on Kanakapura Road, Ramky’s plant is in Dobbespet.
The process

Hospitals are required to segregate solid waste into three categories that are colour coded — yellow, blue and white — to eliminate any scope for confusion. The yellow container carries human anatomical waste, animal waste, microbiological and biotechnological waste, discarded or expired medicines, etc. The blue container carries plastic waste such as IV fluids bottles, tubes, syringes, etc. The white container is for unbroken glasses. Waste sharps, including needles and other sharp tools, go into a separate container.

At the two CBMWTFs, the segregated waste is processed separately where the yellow bin waste is sent to the incinerator.

Blue and white wastes are sent to auto clave/microwave, from where glass waste is routed to registered recyclers. Both plants are working under capacity as only 60 per cent of their capacity is being used for processing biomedical waste.
Benefits of ETPs

While ETPs in Jayadeva Hospital, Jayanagar General Hospital, Kidwai Hospital and K C General Hospital have been operational for more than six months now, the Victoria Hospital campus ETP that caters to five institutes within the campus started functioning just over a month ago.

The benefits have been phenomenal. Almost all these hospitals have recorded at least 15-20 per cent reduction in water bills. The treated water is also being reused mainly for gardening and toilet flushing. The Jayanagar General Hospital has also proposed to sell the extra treated water to the nearby BMTC bus stand to wash buses.

At the K C General Hospital, the treated water was connected to all the toilet flushes a month ago. Dr Vishwaradhya, medical superintendent, says: “The tender has a clause which says the company maintaining the ETP also should set up a lab to test the treated water. We have already allotted space for this.”

At the K R Puram General Hospital, the liquid waste from tanks connected to the labour ward, major operation theatre and laboratory is chemically treated before being released into a common sewage pipeline.
Private hospitals

Some private hospitals in the City have ETPs in place although they are not being used to full capacity. The Manipal Hospital produces around five lakh litres of waste water every day and its ETP capacity is about 500 KLD. The liquid waste is recycled and used for toilet flush tanks and gardens/ponds at the hospital.

Fortis Hospital does not have an ETP, but has a sewage treatment plant (STP) in place. The hospital reuses its treated water for gardening and for the air-conditioning cooling tower.

The Narayana Hrudayalaya Hospitals also does not have an ETP facility. However, with the help of its sewage treatment plant (STP), this hospital has perfected a centralised sewage collecting system.

The BGS Global Hospital does not have an underground drain facility since the hospital is located in Kengeri. However, at its own STP plant, the liquid waste is being treated and let into a pit dug by the hospital.

The Biomedical Waste (Management and Handling) Rules framed in 1998 by the Ministry of Environment and Forests mandates that every hospital, nursing home, clinic, dispensary, laboratory and blood bank should have facility to treat biomedical waste — solid as well as liquid — that will prevent adverse effect to human health and environment.

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